March 18, 2013 | 0 Comments

Petechiae Definition

Petechiae is actually the spot that may be red to purple in color. Petechiae are the plural form of petechiae when there are groups of spots appearing on the skin. They are the result of minor hemorrhage. They may appear like a rash and usually emerge in clusters. These spots appear on the skin particularly of legs. Petechiae are at most instant harmless. They disappear on their own after a few days.

Causes of Petechiae

The most common cause of this petechiae is the injury or trauma. Trauma or injury can be the result of vomiting, crying or coughing. These types of trauma produce fascial petechiae. Petechiae can be a sign of a disease related to low platelet count such as thrombocytopenia. It can also occur if extreme pressure is applied to the tissues such as in excessive vomiting, tourniquet application or in too much coughing.

Petechiae can also occur in the children and in them the most common cause is the viral infection. But sometimes they can be the result of some grave conditions such as leukemia, thrombocytopenia, or meningococcemia. They require an instant support from the doctors.

Non Infectious Causes of Petechiea

Different other non-infectious causes in which petechiae occur include:

  • Idiopathic thrombocytopenic purpura
  • Celiac Disease
  • Hypocalcemia
  • Kawasaki disease
  • Aplastic anaemia
  • Erythroblastosis fetalis
  • Leukemia
  • Lupus
  • Schamberg’s disease
  • Scurvy
  • Kwashiorkor
  • Vitamin K deficiency
  • Marasmus
  • Ehlers–Danlos syndrome
  • Henoch-Schönlein purpura (HSP)

Infectious Causes of Petechiae

There are a number of infections by either bacteria or virus that lead to petechiae formation. These include:

  • Dengue fever
  • Cerebral malaria
  • Bolivian hemorrhagic fever
  • Congenital syphilis
  • Boutonneuse fever
  • Dukes’ disease
  • Cytomegalovirus
  • Endocarditis
  • Crimean–Congo hemorrhagic fever
  • Ebola
  • Influenza A virus subtype H1N1
  • Infectious mononucleosis
  • Hantavirus
  • Neisseria meningitidis
  • Marburg virus
  • Rocky Mountain spotted fever
  • Typhus
  • Scarlet fever

Medicines That Cause Petechiae

This blood disorder may also happen as an adverse effect of certain drugs such as:

  • Warfarin
  • Naproxen
  • Heparin
  • Cimetidine
  • Penicillin
  • Cortisone
  • Carbamazepine
  • Aspirin

Chemotherapy and radiation may also lead to its development in certain circumstances.

Other Causes

Asphyxiation is also the cause of petechiae appearance.  Petechiae formation on the soft palate is chiefly linked with pharyngitis by streptococcal infection. Hard bouts of coughing can lead to appearance of petechiae on the face particularly around the eyes. Allergic reactions due to medications may give rise to petechiae formation and this occurs in response to the body’s reaction.

Symptoms of Petechiae

Well, symptoms depend on the underlying condition in addition to this petechiae spots or a rash. Infectious conditions are accompanies by fever, malaise and flu like symptoms. There are some other manifestations of the particular system involved by the infection.

The petechiae initially is red in colour. It appears in the form of individual blotches in the preliminary stages. With the passage of time, they coalescence together and then appear like a rash then. The petechiae are flat spots that change their colour as the time passes.

It is must that you see your health care practitioner promptly in case you develop the petechiae or your child develops. It’s vital to establish the cause, given that some underlying setbacks can be potentially grave.

Special Characteristics of Petechiae

There are certain features specific to petechiae that help their earlier detection and differentiate them from other rashes and spots.

Size of Petechiae

The size of petechiae is never more than a 3mm. These are the tiny hemorrhagic spots. These are usually 0.5 to 1 mm in diameter. Larger form of petechiae is termed as purpura.

Location of Petechiae

Though, Petechiae can appear anywhere on our body but the particular area where it is commonly seen include legs, face, ankles, back, thigh and the shoulder.

Colour of the Petechiae

Usually the initial colour of the petechiae is red. It appears in the form of a rash. Then it turns to bluish or purplish. Ultimately, its colour turns to dark purple or blue.

Never Fade on Pressure

The characteristic feature of the petechiae is that if they are pressed by applying pressure they never fade i.e. their colour does not lighten.

Petechiae Pictures

Petechia images

Picture 1 : difference between purpura and petechiae

Image source : lowplatelets

Petechiae photos

Picture 2 : Petechiae on medial aspect leg

Image source : calicutmedicaljournal

Petechiae pictures

Picture 3 : Petechiae on lower legs


Picture 4 : Petechiae photos

Image source :

Differential Diagnosis of Petechiae

Diagnosis of petechiae starts with the patient’s history and his/her physical examination. Normally Blood tests are carried out, including:

  • Complete blood count (CBC)
  • Platelet count
  • Bleeding time
  • Prothrombin time
  • Partial thromboplastin time

These tests are necessary and usually ordered to differentiate it from different other causes such as:

  • Hypersensitivity angiitis
  • Purpura
  • Scurvy
  • Rickettsial spots
  • Thrombocytopenia
  • Wiskott-Aldrich syndrome

Petechiae vs Purpura vs Ecchymoses

  • Small lesions (<2 mm) are called – Petechiae
  • intermediate size (2 mm to 1 cm) are called – Purpura
  • larger lesions are called – Ecchymoses

Treatment of Petechiae

The first and foremost way of managing this condition is to correct the underlying cause. If it is corrected, it will automatically correct the condition of the petechiae formation. Other ways to treat petechiae are given below:

Leave The Causative Agent – Medicine

It is must to identity the agent causing these petechiae e.g.  If it is due to a medicine because of an allergic reaction produced by that particular drug, then immediately stop this medicine. It is a simplest way to treat them. It is must to see a doctor in this situation as well.


These are prescribed in case of an infection causing petechia formation and appearance. This way not only petechiae will be treated but also infection will get eradicated.

Application of Ice or Cold Compression

If these petechiea spots are the consequence of injuries to the blood capillaries, then apply ice packs or cold compressions over the affected region. This thing may alleviate the condition. It is suggested that before applying an ice, a paper towel should be put between your skin and the ice pack. This will prevent damage to the skin surface.

Platelet Transfusion

This is recommended in case petechiae are occurring as a result of low platelet count. The platelet transfusion may facilitate to alleviate the condition.

Surgical Option

If petechiae are due to Leukemia or any other malignant conditions, then surgery may be needed to offer a good management.


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